European Radiology

, Volume 29, Issue 3, pp 1435–1443 | Cite as

Feasibility of mapping breast cancer with supine breast MRI in patients scheduled for oncoplastic surgery

  • S. JoukainenEmail author
  • A. Masarwah
  • M. Könönen
  • M. Husso
  • A. Sutela
  • V. Kärjä
  • R. Vanninen
  • M. Sudah
Magnetic Resonance



To prospectively determine the feasibility of preoperative supine breast MRI in breast cancer patients scheduled for oncoplastic breast-conserving surgery.


In addition to a diagnostic prone breast MRI, a supplementary supine MRI was performed with the patient in the surgical position including skin markers. Tumours’ locations were ink-marked on the skin according to findings obtained from supine MRI. Changes in tumours’ largest diameter and locations between prone and supine MRI were measured and compared to histology. Nipple-to-tumour and tumour-to-chest wall distances were also measured. Tumours and suspicious areas were surgically removed according to skin ink-markings. The differences between MRI measurements with reference to histopathology were evaluated with the paired-sample t test.


Fourteen consecutive patients, 15 breasts and 27 lesions were analysed. Compared to histology, prone MRI overestimated tumour size by 47.1% (p = 0.01) and supine MRI by 14.5% (p = 0.259). In supine MRI, lesions’ mean diameters and areas were smaller compared to prone MRI (– 20.9%, p = 0.009 and – 38.3%, p = 0.016, respectively). This difference in diameter was more pronounced in non-mass lesions (– 31.2%, p = 0.031) compared to mass lesions (– 9.2%, p = 0.009). Tumours’ mean distance from chest wall diminished by 69.4% (p < 0.001) and from nipple by 18.2% (p < 0.001). Free microscopic margins were achieved in first operation in all patients.


Supine MRI in the surgical position is feasible and useful in the precise localisation of prone MRI-detected lesions and provides a helpful tool to implement in surgery. Supine MRI more accurately determines tumours’ size and location and might have an important role to diminish overestimations.

Key Points

Breath-hold supine breast MRI is feasible using commercially available coils and sequences.

Size and area of lesions on MRI were consistently smaller when measured from the supine position as compared to the prone position.

Supine breast MRI is useful in the precise preoperative localisation of prone MRI-detected lesions.


Magnetic resonance imaging/methods Breast neoplasms/diagnosis Breast/neoplasms/surgery Humans 



Breast-conserving surgery


Ductal carcinoma in situ


Invasive ductal carcinoma


Oncoplastic breast-conserving surgery


Volumetric interpolated breath-hold examination



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Dr Mazen Sudah MD, PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all patients in this study.

Ethical approval

Institutional review board approval was obtained.


• prospective

• case-control, diagnostic study

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Surgery, Division of Plastic SurgeryKuopio University HospitalKuopioFinland
  2. 2.Department of Clinical RadiologyKuopio University HospitalKuopioFinland
  3. 3.Department of Pathology, Diagnostic Imaging CentreKuopio University HospitalKuopioFinland
  4. 4.Institute of Clinical Medicine, School of Medicine, Clinical RadiologyUniversity of Eastern FinlandKuopioFinland
  5. 5.Cancer Center of Eastern FinlandUniversity of Eastern FinlandKuopioFinland

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